In 1975 the Hawaii prepaid Health Care Act
went into effect, having been passed the year before. The act required all
employers to provide health insurance coverage for all their workers
excluding part-time workers who work less than twenty hours a week, equal to
1.5 percent of their wages or 50 percent of the insurance premium. Owing to
this, 96 percent of Hawaiians have health insurance, compared to the pre-act
17 percent, with the unemployed and seasonal workers being covered by state
subsidies. The coverage encapsulates hospital bills and physician visits,
but not prescription medications, vision care, or dental. The result has
been, in general, extremely satisfying to the public, and the people have
come to enjoy healthier lives, including the lowest level of mortality from
breast cancer in the nation, as well as one of the lowest infant mortality
rates. Moreover, health costs are thirty percent lower compared to the
mainland, with competition from Kaiser Permanente HMO and Hawaii Medical
Service Association (a Blue Cross organization) contributing to these low
prices, as well as the nature of the system spreading the risk of an
expensive procedure over the entire state, also assisting in this lessening
of costs.

The initial impact of the bill affected
small businesses the most, as most large-businesses at the time of enactment
all ready provided healthcare. However, despite what may be considered the
usual course, the rise in costs owing to the imposition of this mandatory
insurance did not significantly cause businesses to collapse, nor did
unemployment rise. In fact, more small businesses than any other state in
the nation actually support the notion of compulsory health insurance, as
well as many small businesses that opt to pay the entire premium seeing
their insurance coverage as a way of helping them keep their valued workers.
Big businesses share this general approval, also. Of course, not every
aspect of the system is liked, with businesses being concerned as to whether
or not the state would keep costs reasonable, a fear which was made manifest
when the state mandated that all health insurers and HMOs add mental health,
drug and alcohol treatment, mammograms, well-baby care, and in vitro
fertilization to their coverage. Resenting this move, the businesses
rightfully wonder what next they shall be forced to pay.

Despite the success of this system in
Hawaii, it is not necessarily nationally applicable. Hawaii enjoys a small
population, a healthful climate, and a workforce heavily apart of unions
which can influence businesses. Hawaii has also enjoyed low unemployment and
owing to the fact that it has more physicians than specialists, has always
been on the vanguard of providing preventive care which ultimately leads to
less expensive procedures down the road. That this is not the case in other
states would inhibit the capacity for those states to have such a system, as
well as the fact that owing to geographical limitations, businesses have
less of an opportunity to move out of Hawaii. Whether a similar, although
adjusted, system might not be applicable in other states, is yet still a
matter of dispute.

The Canadian System:

Owing to the United States’ medical system
failing to provide for all, some people have increasingly looked towards our
neighbour to the North for a new system which may better suit our extensive
needs. Canada, in contrast with the United States, has adopted, since 1971,
a single-payer national health insurance, which provides one-hundred percent
coverage, and although not without draw backs, is worthy of further
investigation.

As noted, the Canadian system was
established in 1971, and unlike Great Britain’s system, the Canadian
government neither nationalized hospitals nor made doctors employees of the
government, but rather did it eliminate most forms of private medical
insurance to be replaced by a government plan which was to be administered
by the ten Canadian provinces. Paid for by a variety of provincial and
federal taxes, it is not so much “socialized medicine” as critics called,
but more analogous to Medicare or Social Security. Moreover, the
comprehensiveness of the system can be seen that under the plan physician
services, diagnostics, testing, hospitalization, surgery, long-term care,
prescription drugs for those over sixty-five, and mental-health care are all
covered, with the need for private insurance in Canada regulated to the few
things which are not covered under the Canadian system. Also, although there
is freedom given to the provinces in exactly how much to cover people, each
provincial system must correspond to the five principles of the Canadian
Health Act, namely, universality, portability, accessibility,
comprehensiveness, and public administration. Owing to all this, each
Canadian citizen is guaranteed access to a physician and may go to see any
primary-care physician wanted and no cost will be incurred should one need
hospitalization, testing, or surgery. No patient bills, claim forms,
co-payments, or reimbursement is necessary under the Canadian system, with
there being only a need to show one’s ID card to get medical services. After
treatment physicians need only send the bill to the provincial insurance
plan and within two to four weeks he is paid. By minimizing paperwork, this
portion of the system is particularly suited for cutting unnecessary
expenditures. This system also enjoys an exceedingly high popular rate, with
nine out of ten Canadians affirming in 1992 that the health care system is
one of the few things which makes Canada the best country in the world to
live, with only three percent of Canadians in another poll wishing for an
Americanized system, although popularity as a whole for the Canadian system
has lowered over the last decade. Most importantly, it also seems to work at
both reducing costs and keeping a high level of success, with the infant
mortality rate in Canada actually being lower than the United States.

The Canadian physician is not, on a whole,
displeased with this system, either. Although they make less money than
their American counterparts, the reduced burden of paperwork and insurance
hassles usually makes up for this in part, although some physicians still
are not pleased with having to fixed fees for their services determined by
the government and Canadian physicians see more patients than their American
counterparts. Moreover, the Canadian system, being more focused on primary
care, produces more Canadian physicians who are general care practitioners,
as opposed to the increasing specialist preponderance in America.

The Canadian system is, however, not
perfect. High-cost medical technology is not nearly as invested in, with the
United States usually leading Canada with several times the amount.
Similarly, owing to the general-care focus, Canada significantly lags behind
the United States in specialist care. Owing to this, long-wait times are
common whenever a Canadian must avail himself of these resources, sometimes
even reaching the six month point. However, not all procedures have this
wait time, with the Canadian government showing treatment usually starts
within a week of requesting. Yet despite the Canadian government saying
otherwise, it would seem that Canadians support some reform to fix this flaw
in their system, with 74% reporting that they’d support user fees that would
reduce demand on the medical system in order to hasten the process. Canada
has also cut revenue sharing with the provinces, forcing many mergers or
closures of hospitals, alongside other limitations placed on the places
available for Canadian medical schools. With rising demands, many have also
taken to crossing the border to the States in order to seek medical
treatment there, with some suggesting that this may be stopped if Canada
allows for some for-profit private hospitals to offer Canadians with the
money to pay for services that which they desire. In 2002, the government
also suggested that $4 billion dollars more be spent on health care to help
tackle some of these problems, but critics point out that this may simply be
shoveling money onto a system which needs fundamental change, not more
money.

Although positive in many respects, many
believe the Canadian system would not fit within the American national
character, owing to its restrictiveness, the individualism of the American
people, and the unwillingness to vastly increase taxes for medical coverage.
Others, however, hold to a more enthusiastic view of the possibilities for
the Canadian system to address US woes over the uninsured, the portability
of insurance, the lack of universal access, and rising prices. Yet despite
what would happen otherwise, if the US were to switch to the Canadian
systems, both the insurance companies, doctors, and hospitals would all, to
varying degrees, suffer financially, although at the same time, some doctors
may be more free to practice medicine in a manner which they deem best.
Currently, there is no true resolution to whether or not Canada could
provide a model for the United States, and there are no plans in the works
to truly change the US system towards it.

Brian and
his Gaucher’s disease, treated with orphan drug
by Paola Kasouto(NCC, 2009)

Brian, a 2 year old was diagnosed with gaucher’s
disease when his spleen grew abnormally large. He was one of
the people used to experiment on with the drug Genzyme. His
condition got extraordinarily better, but when taken off the
drug it worsened critically. He has continued biweekly
infusions of the drug and is currently in astounding health,
leads a normal life, and has a passion for swimming. The
downside to his situation is the cost of the medication. It
costs around $360,000 a year, therefore it was hard for his
father to find a job that would cover this particular expense.
The job he was currently at when his son got diagnosed was very
small therefore the cost would be spread amongst a few amount of
people so he had to find a larger company to work for. He now
works for a cable company going to about 60-70 doors everyday,
but he says it’s very worth it but fears for his son’s future
and how would he manage the cost of his treatment. The reason
for such high costs is due to the rarity of the disease leading
to high costs to be able to cover for the production of the drug
as well as a significant profit for the drug companies.

This
article consists of a compilation of rare diseases. One of the
diseases is Tourette’s which drug companies don’t want to
research a drug to help cure it. There was research underway
but it got terminated. Then there’s a case of Gaucher’s disease
in which the situation above was described. He states “Do you
know how many employers Brian may put bankrupt?”

This
article describes the US’s orphan drug law and how it grants the
manufacturer 7 years of no competition, meaning that no other
company is allowed to produce the drug with the same active
ingredient. This law is believed to be responsible for the
surge in orphan drugs to the market.

Discription: How the drug companies discontinue making an Orphan Drug
because too few "patients" will be purchasing them in order to bring in
the big bucks. What
is an Orphan Drug?Article describes what an orphan drug is, and how
the United States and European Union governments support orphan drug
research and development.

Find information here about drugs developed
to treat rare diseases and disorders.

Top Orphan Drugs Approved in 2008Marketing approval for
orphan drugs, specialty drugs
created to treat rare diseases, is always exciting. In 2008, the U.S.
Food and Drug Administration (FDA) approved several of these drugs that
were particularly important.

Two Orphan Drugs ApprovedTreatments are now available in the U.S. for
two rare diseases: Fabrazyme, for Fabry disease, and Aldurazyme, for MPS
I. Both are storage disorders with devastating effects in their severest
forms.

Orphan Drugs Approved in 2005These orphan drugs (specialty drugs to treat
rare disorders or conditions) were20approved by the U.S. Food and Drug
Administration (FDA) for marketing in the U.S. in 2005. Internet links
for more information are provided where available.

Orphan Drugs Approved in 2004These orphan drugs (specialty drugs to treat
rare disorders or conditions) were approved by the U.S. Food and Drug
Administration (FDA) for marketing in the U.S. in 2004. Internet links
for more information are provided where available.

Orphan Drugs Designated in 2003These drugs and treatments were granted
orphan drug status by the U.S. Food and Drug Administration in202003.
With each drug is listed what condition it is designed to treat, and
which company is sponsoring it. Links to more information are provided
where available.

Orphan Drugs Approved in 2003These orphan drugs (specialty drugs to treat
rare disorders or conditions) were approved by the U.S. Food and Drug
Administration (FDA) for marketing in the U.S. in 2003. Internet links
for more information are provided where available.

Orphan Drugs 2002Here is a list of the orphan
drugs--medications and treatments for rare diseases--approved in 2002
for marketing, with links to more information about them and the
conditions they were designed to treat.

FDA Puts Hold on Gene Therapy StudiesThe U.S. FDA temporarily halted gene therapy
studies after two children who receive d this experimental therapy for a
rare disorder developed cancer. The studies will most likely resume, but
with new cautions.

Vaccines for Rare DiseasesWhat is an orphan vaccine? Why isn't this
method of prevention or treatment being developed? Learn how you can
network with other concerned individuals, participate in clinical
trials, and advocate for more research and development.

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